Long-lasting allergic patch test reactions to nickel sulfate: analysis by nickel quantification and immunocytochemistry

We previously showed the median duration of positive patch test reactions to nickel sulfate (5% pet.) was 9 days, and defined as long-lasting (LLAPTR) the 14.3% of reactions that persisted for 17 days or longer. The pathomechanisms of LLAPTR are unclear, but may involve either localized antigen persistence or abnormal downregulation of the cellular immune response. In this study, we compared (a) the nickel concentration and (b) the immunocytochemical nature of the local immune reaction, between biopsies from LLAPTR (n = 8) and normally resolving allergic patch test reactions (NRAPTR) (n = 8) to nickel sulfate. The concentration of nickel in LLAPTR (median 0.56 microgram/g, range 0.25-3.87 micrograms/g, mean 0.83 microgram/g, 95% CI 0.35-1.31) and NRAPTR (median 0.58 microgram/g, range 0.2-1.85 micrograms/g, mean 0.88 microgram/g, 95% CI 0.02-1.74) was similar. Activated T lymphocytes, expressing surface IL-2 receptor, HLA DR, DR alpha 1, DP, DQ, and CD2 > CD8 > CD4 antigens, were seen throughout the dermis and occasionally infiltrating the suprabasal layer of the epidermis in all biopsies. CD1 and HLA DR, DR alpha 1, DP, and DQ-expressing Langerhans cells were present throughout the epidermis and occasionally seen in the papillary dermis. HLA DR, DR alpha 1, DP, and DQ antigen expression were also seen on the surface of non-dendritic cells in the epidermis (probably either keratinocytes or T lymphocytes) and vascular endothelial cells in the papillary dermis. There were no significant qualitative or quantitative differences in the immunocytochemical nature of the localized immune reaction between LLAPTR and NRAPTR. These findings suggest that the pathomechanism of LLAPTR to nickel sulfate is unlikely to be explained simply on the basis of nickel concentration or the nature of the localized immune reaction at the patch test site.

Genetic manipulation of rumen bacteria: from potential to reality

The development of techniques for manipulating the molecular genetics of bacteria led naturally to suggestions for using this technology to alter rumen function. Despite early difficulties, methods are now available to insert new genetic material into several rumen bacterial species, including Butyrivibrio fibrisolvens, Prevotella ruminicola, and Ruminococcus albus. One strain of B. fibrisolvens has been modified to detoxify a naturally occurring poison that causes major losses of livestock in Australia, Africa, and Central America. The stability of that modified organism has been demonstrated by its recolonization of the rumen and retention of its altered genotype over 5 months in vivo. Many of the persistent doubts about rumen bacterial genetic manipulation and the viability of altered organisms in a competitive environment have been shown to be capable of resolution, and interest in this area of research may be revitalized by these results. Apart from the achievement of specific metabolic improvements, the technology now available will allow extensive characterization of the molecular genetics of rumen bacteria with a precision that was not previously possible.

Transcription of interferon-alpha 2 alleles from virus-induced human leucocytes and lymphoblastoid cells of African origin

It has been previously shown that the genomic DNA of both the lymphoblastoid cell line (Namalwa) and certain human donors (of African origin) contain sequences corresponding to two allelic variants, b and c, of the interferon-alpha 2 gene (IFNA2). Little is known however about the relative expression of these two alleles in heterozygous cells. We have therefore examined the transcription of allelic variants of the human IFNA2 locus by both normal human leucocytes (from a heterozygous donor) and Namalwa cells. Analysis of cDNA clones identified sequences of both allelic variants, IFNA2b and c, indicating active transcription by both cell types. Analysis of tryptic and peptic peptides derived from purified IFN-alpha 2 also demonstrated both IFN-alpha 2b and IFN-alpha 2c proteins. Populations of virus induced heterozygous cells can therefore effectively transcribe and secrete both forms of IFN-alpha 2 simultaneously, with no apparent restrictions on expression of either allele.

Acute effects of ozone on the pulmonary function of exercising schoolchildren from Mexico City

The acute effects of ozone (O3) on the change in lung function before and after exercise was assessed in 22 boys and 18 girls from 7 1/2 to 11 yr of age tested up to eight times over a 1 1/2-yr period outdoors (under a tarpaulin) at a school in Mexico City. Ozone and particulates were monitored at an adjacent government station, in the school yard, and under the tarp. Subjects were selected to oversample children with chronic respiratory symptoms, although children with active asthma under regular medication or FEV1 < 80% predicted were excluded. Of the participants, 21 had chronic cough, chronic phlegm, or ever wheeze with colds or apart from colds. Children performed two cycles of treadmill exercise (15 min) and rest (15 min) for a total of 1 h of intermittent exercise. Most subjects attained the target minute ventilation of 35 L/min/m2. Subjects exercised alternately during low ozone hours (8:00-10:00 A.M.) and during peak O3 hours (12:00-2:00 P.M.), to assure a range of exposures. On 85% of exercise days, the maximum daily 1-h average for ambient O3 exceeded the Mexican guideline of 110 parts per billion (ppb). O3 exposure during the hour of exercise was divided into quintiles, and the response was adjusted for repeated measures, subject having a cold, and prior outdoor exercise. Ambient O3 in the fifth quintile (mean = 229 ppb) was associated with a percentage change in FVC (-1.43% +/- 0.70), FEV1 (-2.85% +/- 0.79), FEF25-75% (-6.32 +/- 1.87) and FEV1 (-1.41% +/- 0.46).(ABSTRACT TRUNCATED AT 250 WORDS)

Meeting infection control standards in the OR

Quality health care is associated with the absence of negative outcomes in patients. Institutions realize that quality cannot be assured but it can be assessed and methods can be developed to improve patient care. Many heath care institutions, therefore, have begun the conceptual transition from quality assurance model to principles of continuous quality improvement (CQI). This article describes a CQI project that was developed to enhance infection control standards in OR settings. The project involved three phases: development of a survey tool, implementation of an environmental assessment and monitoring model, and transfer of the model to OR staff members. Five months after implementation of the model, the chi-square test revealed there was a significant improvement in compliance (chi 2 = 5.0, P < .03). After 22 months of using the model, compliance to infection control standards remains high and OR staff members have taken ownership of the model by incorporating it into their departmental CQI process.

Linear IgA disease (LAD): immunoglobulin deposition in oral and colonic lesions

Two cases of adult linear IgA disease (LAD) with oral and colonic involvement are presented. Oral findings, for both patients, were of widespread painful ulceration present for two to three months and diagnosis was confirmed by biopsy and direct immunofluorescence. Colonic symptoms preceded oral symptoms in both cases and a number of investigations were undertaken, including routine histological examination, which suggested either lymphocytic colitis or Crohn's disease. Immunofluorescence studies showed linear IgA deposition confined to the distal colon. These cases highlight that large bowel involvement can be a feature of linear IgA disease and for the first time demonstrate IgA deposition at that site.

Quantitative variation in sets of triplets and quadruplets: a simulation

A computer simulation was devised to generate realistic but large samples of twins, triplets, and quadruplets in each of the possible zygosity types. To validate the simulation, I used formulas proposed by Richter and Geisser (1960) to predict the mean value of the sum of squared deviations in each of three types of triplets and five types of quadruplets and to predict the distributions of the sums of squares in pure types (e.g., monozygotic and trizygotic triplets). Use of the formulas to predict distributions in sets of mixed type or to diagnose zygosity requires more advanced mathematical methods, but the simulation readily generates standard populations of all types of sets. If large enough numbers of real triplets or quadruplets ever become available to permit useful comparison with these standards or with the formulas, developmental peculiarities of the higher-order births might be revealed.

Major histocompatibility complex class I-restricted cytotoxic T-lymphocyte responses in horses infected with equine herpesvirus 1

An experimental system that permits sensitive and reproducible detection of equine herpesvirus 1 (EHV-1)-specific cytotoxic T-lymphocyte (CTL) activity in the horse was developed. Peripheral blood mononuclear cells (PBMC) collected from immune horses were restimulated in vitro by culture with live EHV-1. Cytotoxic activity against virus-infected, pokeweed mitogen-stimulated lymphoblast targets was assessed in a 4-h 51Cr release assay. The optimal conditions for in vitro stimulation of equine memory CTLs and for preparation of EHV-1-infected target cells expressing viral antigens were systematically identified by individually testing the effects of variations in responder cell concentration, culture medium composition, serum type, incubation time, antigen form, and exogenous mediator content. By using this optimized system for generation and assay of equine CTLs, the development of EHV-1-specific cytotoxic responses in 12 horses was evaluated after experimental viral infection. CTLs with the capacity for killing EHV-1-infected target cells were detected in equine PBMC as early as 1 week postinfection, reached maximal levels by 2 to 3 weeks, and remained detectable for a year after infection. Equine effector cells mediating lysis of EHV-1-infected targets were predominantly CD8+ T lymphocytes, and the cytotoxicity was specific for virus and restricted by major histocompatibility complex class I molecules. The results define a reliable and convenient experimental system for generation and assay of EHV-1 CTLs which can now be used for more-detailed characterization of the equine CTL response to infection by this herpesvirus pathogen.

Detoxification of the plant toxin fluoroacetate by a genetically modified rumen bacterium

We isolated the fluoroacetate dehalogenase gene (H1), from Moraxella species strain B, and placed it under the transcriptional control of a 154 bp fragment of the erm gene promoter. The promoter/gene construct was attached to the Butyrivibrio fibrisolvens shuttle vector pBHerm, and the resulting dehalogenase expression plasmid (pBHf) was transferred to B. fibrisolvens OB156 by electroporation. The erm gene promoter directed expression of dehalogenase activity in both E. coli and B. fibrisolvens OB156. Cell-free lysates of the genetically modified OB156 defluorinated 10.6 nmol fluoroacetate/min/mg protein. Growing cultures of OB156 were able to detoxify fluoroacetate in the culture medium, at the rate of 9.9 nmol/min/mg. Plasmid pBHf was retained by 100% of OB156 cells after 500 generations of non-selective culture. The restriction pattern of pBHf remained unchanged after extensive non-selective growth and host bacteria continued to produce active dehalogenase. The construction of rumen bacteria that are able to detoxify an important natural poison supports the feasibility of using genetically modified rumen bacteria to aid animal production.

The effects of sex steroids, and the X chromosome, on female brain function: a study of the neuropsychology of adult Turner syndrome

Sex steroids and the X chromosome can independently affect cognitive abilities. Because subjects with Turner syndrome (TS) have gonadal aplasia, and various alterations in X chromosome structure and number, they provide a model to study the effects of sex steroids and of the X chromosome on human brain function. We used neuropsychological tests to study the cognitive abilities of 18 TS adults and 19 age/sex matched healthy controls. Nine TS subjects were mosaic for the 45,X karyotype, and 9 were non-mosaic 45,X (full TS). The TS group as a whole, compared to controls, had (i) significantly lower scores in tests of language and visual-spatial function, attention and memory, and (ii) a significantly greater discrepancy between verbal and performance scores. Mosaic TS subjects were intermediate between full TS and controls in some tests of verbal ability, but did not differ significantly from controls in others. Visuospatial ability was significantly lower than controls in both mosaic and full TS. Within the mosaic TS group, there was a significant negative correlation between visuospatial ability and % lymphocytes having a 45,X karyotype. Memory test scores were reduced independently of "X chromosome dosage" in all TS subjects. We conclude that in humans, the X chromosome is involved in development of both cerebral hemispheres, but moreso of the association neocortices. Also, sex steroids may modulate this effect--particularly in hippocampus.

Helping homeless mentally ill people: what variables mediate and moderate program effects?

This process evaluation study examined what variables moderate and mediate treatment effects on days in stable housing and client satisfaction for homeless mentally ill clients. In general, demographic characteristics did not moderate either outcome variable. Housing contacts, entitlement contacts, mental health contacts, and supportive services were significant mediators of the treatment effect on days in stable housing. Program contacts, mental health contacts, and supportive services were significant mediators of client satisfaction.

Reducing the risk of tuberculosis transmission

Hospital workers are understandably concerned about the risk of acquiring tuberculosis (TB) as they perform their duties, so institutions throughout the United States are developing and implementing procedures to lower the risk of TB transmission in the healthcare setting. The TB infection control plan at University Hospital of Brooklyn is described.

Did reflexive catalysts drive chemical evolution?

High-energy starting materials and energy sources on the primitive earth would have generated abundant and varied organic molecules of small or medium size. It is questionable, however, whether ordinary chemical evolution could have produced information-carrying polymers. The end point might have been a fixed steady state if some form of autocatalysis had not intervened. Autocatalytic synthesis is possible for small molecules as illustrated by the formose reaction, in which glycolaldehyde condenses with formaldehyde to form sugars, and resulting tetroses may cleave into two molecules of glycolaldehyde. This and other 'reflexive catalysts', some functioning in molecular aggregates, may have energized chemical evolution and carried it to a level at which RNA or an RNA analog could replicate itself.

X-chromosome effects on female brain: a magnetic resonance imaging study of Turner's syndrome

Many neuropsychiatric disorders differ between the sexes in incidence, symptoms, and age at onset. To investigate the effects of X-chromosome aneuploidy and of sex steroid deficiency during childhood on brain structure and function, we used neuropsychological tests and quantitative magnetic resonance imaging (MRI) to study the brains of eighteen women with Turner's syndrome (TS) and nineteen healthy control women of similar age. Nine TS subjects had mosaic 45,X karyotypes, and 9 had non-mosaic 45,X. The TS group had significantly lower scores than the controls for all the Wechsler adult intelligence scale tests, except verbal comprehension and reading level. The greatest difference was in visuospatial construction (mean 90 [SD12] vs 118 [13], p < 0.0001). The TS subjects also had a greater discrepancy than controls between verbal and performance intelligence quotients (9 [8] vs -5 [9], p < 0.001). We found that TS subjects had significantly smaller values than controls in MRI-measured volumes of hippocampus, caudate, lenticular, and thalamic nuclei, and parieto-occipital brain matter, on both sides. Women with mosaic TS had values between the full TS and control groups for cerebral hemisphere and lenticular and thalamic nuclei volume and for verbal ability. Within the mosaic TS group, visuospatial ability was significantly correlated with the percentage of lymphocytes that had the 45,X karyotype. Hippocampal volume and memory test scores were significantly lower in mosaic and non-mosaic 45,X TS subjects than in controls. We postulate that in human beings the X chromosome plays an important part in the development and ageing of grey matter in striatum, diencephalon, and cerebral hemispheres.

The DNA sequence of the equine herpesvirus 4 gene encoding glycoprotein gp17/18, the homologue of herpes simplex virus glycoprotein gD

The nucleotide sequence of the gene to the left of the gI gene of equine herpesvirus 4 (EHV-4) was determined. The gene encodes a peptide of 402 amino acids with an unprocessed M(r) of 45,323. The predicted polypeptide has several features of a glycoprotein including a hydrophobic signal sequence, a membrane spanning domain and four potential N-linked glycosylation sites within the proposed external domain. The predicted amino acid sequence of EHV-4 gD shows 83% identity with that of equine herpesvirus 1 gD. Conservation of the tertiary structure is suggested by the alignment of six cysteine residues with those of the gD of six other alphaherpesviruses. Screening a lambda gt11/EHV-4 expression library with monoclonal antibodies against several of the most abundant EHV-4 glycoproteins unequivocally identified the protein encoded by the EHV-4 gD gene as gp17/18.